Thursday, July 5, 2012

If doctors are transmogrified into glorified cogs in a
bureaucratic machine, then your relationship with your doctor, the old
human-to-human thing, will necessarily be eroded.

So says Daniel Henninger this morning in the Wall Street
Journal. Surely, he is right.

Obama was smart to focus the health care debate on insurance
claims. When Obama promised that you would be able to keep your doctor, he may have been lying or he may not have known any better. Reality was never his strong suit.

At the least, it was a clever rhetorical ploy. It blinded almost everyone to the question of whether
or not Obamacare would have any real effect on the quality and
availability of care.

Obama did not, Henninger explains, ask the doctors whether, under Obamacare, they
would be able to continue to provide the same medical care.

If the new medical regime rewards doctors for “volume,” he
adds, that means that they will have a lesser incentive to spend time with an
individual patient or to work on a specific case.

And what makes you think that the medical profession will
continue to attract the best and the brightest young people.

A few years ago I was chatting with a heart surgeon friend.
He was explaining that, given the average age of a heart surgery patient, his
specialty had been taken over by Medicare.

If the surgeon believes that two surgeons are necessary to
perform a bypass and Medicare will only pay for one, the second
surgeon's place will be taken by a nurse.

The standard of care will necessarily deteriorate.

He added that when he did his residency around four decades
ago there were around 600 applicants for 120 heart surgery residencies. Today there are 60 applicants for the same 120
slots.

Does this increase or decrease your confidence in young
heart surgeons?